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How does this medication work? What will it do for me?

The tablet form of desmopressin belongs to the class of medications known as antidiuretics. It is a hormone taken by mouth to control excessive urination during the night (bedwetting). It is also used to treat central diabetes insipidus, a condition where the kidneys are unable to conserve water due to a lack of antidiuretic hormone (ADH). This condition causes frequent urination and thirst. Desmopressin is also used to treat temporary conditions of frequent thirst and urination after head trauma or surgery in the pituitary gland.

This medication works by acting on the kidneys to reduce the amount of urine they produce. It usually starts to work within an hour and lasts for 7 to 9 hours.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

For controlling excessive urination at night, the usual starting dose for oral tablets (i.e., taken by mouth and swallowed) is 0.2 mg taken one hour before bedtime. The usual starting dose for sublingual tablets (to be placed under the tongue) is 120 µg taken one hour before bedtime. You should limit your fluid intake for a few hours before taking this medication. In addition, you should limit the amount of alcohol and caffeine you consume during evening hours. Depending on your response to this medication, your doctor may gradually increase the dose to 0.6 mg at bedtime for oral tablets or 360 µg at bedtime for sublingual tablets.

For central diabetes insipidus, the usual starting dose for oral tablets is 0.1 mg taken 3 times daily. The usual starting dose for sublingual tablets is 60 µg taken 3 times daily. Your doctor will then adjust the dose depending on your response to this medication. The maximum dose for oral tablets is 0.4 mg taken 3 times daily. The maximum dose for sublingual tablets is 240 µg taken 3 times daily.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you are taking this medication for controlling excessive urination at night and you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you are taking this medication for central diabetes insipidus and you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

have conditions leading to low sodium in the blood (e.g., bulimia, anorexia nervosa, chronic vomiting, diarrhea, and adrenal impairment)

have type IIB or platelet type (pseudo) von Willebrand's disease

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

flushing or redness of skin

headache

nasal congestion

runny nose

stomach cramps

upset stomach (nausea)

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

confusion

flushing

headache (continuing)

nausea

vomiting

weight gain

Stop taking the medication and seek immediate medical attention if any of the following occur:

seizures

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood pressure: This medication may occasionally cause increases in blood pressure. If you have high blood pressure or heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed

Cystic fibrosis: People with cystic fibrosis are more likely to experience low levels of sodium in the body. This can lead to increased side effects with desmopressin. If you have cystic fibrosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Fluid and electrolyte balance: Fluid intake should be adjusted in order to reduce the possibility of water retention and low levels of sodium in the blood, especially for very young people and for seniors. People who are dehydrated should wait until their water balance has been adequately restored before taking desmopressin. Seniors should be closely observed for possible water retention and low sodium in the blood due to excessive fluid intake. Talk to your doctor about adjusting the amount of fluid intake that is right for you. For control of nighttime urination, a restricted fluid intake is recommended a few hours before using this medication.

Lactose intolerance: The regular tablet form of this medication contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take this formulation. The sublingual tablet formulation does not contain lactose.

Short-term illnesses: Many short-term illnesses such as fever, infections and stomach irritation can cause dehydration. This dehydration may cause complications with the use of desmopressin. Talk to your doctor about how to manage your desmopressin treatment if you develop a short-term illness.

Tolerance: There are reports of changes in response over time, usually when the medication has been used for periods longer than 6 months. Some people may experience decreased responsiveness, while others may experience a shortened duration of effect.

Urinary tract problems: If you have severe bladder or voiding problems, the way your body gets rid of excess water or sodium may be impaired. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication has been used during pregnancy with no harm reported. However, no controlled studies have been done on its use by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if desmopressin from desmopressin tablets passes into breast milk. If you are a breast-feeding mother and are taking desmopressin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Children are more likely to experience low sodium levels and fluid build up as a result of consuming too much fluid. Your child’s doctor should closely monitor fluid and sodium levels while your child is taking desmopressin.

Seniors: Seniors are more likely to experience low sodium levels and fluid build up as a result of consuming too much fluid or decreased kidney function. Your doctor should closely monitor your condition while you are taking desmopressin.

What other drugs could interact with this medication?

There may be an interaction between desmopressin and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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